Hand Flashcards

1
Q

What’s the most frequently fractured carpal bone?

A

Scaphoid

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2
Q

What’s the most frequently dislocated carpal bone?

A

Lunate

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3
Q

Which wrist bone is found w/in the tendon of the flexor carpi ulnaris?

A

Pisiform

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4
Q

Which wrist bone has a hook-like process and what is it called?

A

Hamate, hamulus

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5
Q

Which carpal bone is the longest & 1st to ossify?

A

Capitate

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6
Q

Which carpal bone has a saddle-shaped facet for the 1st metacarpal and a tubercle for attachment to the flexor retinaculum?

A

Trapezium

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7
Q

What dermatome covers the thenar eminence?

A

C6

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8
Q

What dermatome covers the index and middle finger?

A

C7

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9
Q

What dermatome covers the ring and pinky finger?

A

C8

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10
Q

When the deep palmar fascia reaches the palm, it’s known as the _____. What tendon inserts into it?

A
  • Palmar aponeurosis

- Palmaris longus tendon

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11
Q

What causes Dupuytren’s contracture? What are its sx?

A
  • Progressive fibrosis from palmar aponeurosis to base of phalanges
  • Pulls digits into flexion at the metacarpo-phalangeal joints (so they can’t be straightened)
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12
Q

Tendons of the fingers are surrounded by _________.

A

Synovial sheaths

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13
Q

What are the boundaries of the carpal tunnel?

A
  • Anterior: flexor retinaculum

- Posterior: carpal bones

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14
Q

What lies w/in the carpal tunnel?

A
  • 4 tendons of the flexor digitorum superficialis
  • 4 tendons of the flexor digitorum profundus
  • 1 tendon of flexor pollicis longus
  • Median n.
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15
Q

What are some possible causes of carpal tunnel syndrome? What n. is affected? What are the sx?

A
  • Fluid retention, infection, excessive exersize
  • Median n.
  • Wasting of the thenar mm. (can’t oppose thumb)
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16
Q

What mm. are in the thenar compartment of the hand and what are they innervated by?

A
  • OAF:
    1. Opponens pollicis m.
    2. Abductor pollicis brevis m.
    3. Flexor pollicis brevis m.
  • Median n. (recurrent branch)
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17
Q

What mm. are in the hypothenar compartment of the hand and what are they innervated by?

A
  • OAF:
    1. Opponens digiti minimi m.
    2. Abductor digiti minimi m.
    3. Flexor digiti minimi brevis m.
  • Ulnar n.
18
Q

Adductor pollicis m. innervation and action?

A
  • Ulnar nerve (deep branch)

- Adducts thumb

19
Q

Abductor digiti minimi m. innervation and action?

A
  • Ulnar nerve (deep branch)

- Adducts little finger

20
Q

Flexor digiti minimi brevis m. innervation and action?

A
  • Ulnar nerve (deep branch)

- Flexes proximal phalanx of little finger

21
Q

Opponens digiti minimi m. innervation and action?

A
  • Ulnar n. (deep branch)

- Draws 5th metacarpal anteriorly and rotates it to face thumb

22
Q

Dorsal interosseous mm. (DABs) innervation and action?

How many are there?

A
  • Ulnar n. (deep branch)
  • Abducts digits from axial line of hand (3rd digit), flexes digits at metacarpo-phalangeal joints, extends interphalangeal joints
  • There are 4 (2 on middle, pinky has it’s own abductor so none on pinky)
23
Q

Palmar interosseous mm. (PADs) innervation and action?

How many are there?

A
  • Ulnar n. (deep branch)
  • Abducts digits from axial line of hand (3rd digit), flexes digits at metacarpo-phalangeal joints, extends interphalangeal joints
  • There are 3 (none on middle finger)
24
Q

Lumbrical mm. (1st and 2nd) innervation and action?

A
  • Medial n. (digit branches)

- Extends digits at interphalangeal joints, flexes at metacarpo-phalangeal joints (can touch pulp of fingers)

25
Q

Lumbrical mm. (3rd and 4th) innervation and action?

A
  • Ulnar n. (deep branch)

- Extends digits at interphalangeal joints, flexes at metacarpo-phalangeal joints (can touch pulp of fingers)

26
Q

Palmaris brevis m. innervation and action?

A
  • Superficial palmar branch of ulnar n.

- Deepens hollow of hand, assists grip

27
Q

Abductor pollicis brevis m. innervation and action?

A
  • Medial n. (recurrent branch)

- Abducts thumb

28
Q

Opponens pollicis m. innervation and action?

A
  • Median n. (recurrent branch)

- Draws 1st metacarpal forward and rotates it medially

29
Q

What is the basic arterial supply to the hand?

A

-USRD: Ulnar a. superficial, radial a. deep

30
Q

What happens to the ulnar a. once it enters the hand?

A
  • Divides into superficial branch and deep brach of ulnar a.
  • Superficial branch then becomes superficial palmar arch (gives off common palmar digital and proper palmar digital aa. as it moves across hand)
31
Q

Where are the common palmar aa.?

A

-Pass b/w metacarpals (comes from superficial branch of ulnar a.)

32
Q

Where are the proper palmar digital aa.?

A

-Run on either side of digits 2-5 (comes from superficial branch of ulnar a.)

33
Q

Where is the deep branch of ulnar a.?

A
  • Passes b/w abductor digiti minimi and flexor digiti minimi mm.
  • Anastomoses w/deep palmar arch
34
Q

Describe radial a.’s path to the hand?

A

-Continues dorsally over lateral carpal bones, extends across the floor of the snuff box, and pierces the 1st dorsal interosseous m.

35
Q

What aa. come off from the radial a. in the hand?

A
  • Princeps pollicis a. (medial thumb supply)
  • radialis incidis a. (lateral 2nd digit supply)
  • Continue to deep palmar arch, which will anastomose w/deep branch of ulnar a.
  • Superficial palmar branch (found at midpoint of metacarpal)
36
Q

What nerves do the median n. branch into in the hand?

A

Common palmar digital and proper palmar digital branches

37
Q

What nerves do the ulnar n. branch into in the hand?

A
  • Palmar cutaneous branch (medial palm)
  • Dorsal cutaneous branch
  • Superficial branch (becomes common palmar digital nerves and then proper palmar digital nerves)
    (- Deep branch, not highlighted)
38
Q

What nerves do the radial n. branch into in the hand?

A
  • Superficial branch

- Dorsal digital nerves

39
Q

What causes claw hand/ulnar claw? What are the sx?

A
  • Ulnar n. palsy causes unopposed activity of the extensor digitorum m.
  • Intrinsic hand m. weakness; hyperextension of 4th and 5th metacarpophalangeal joints, flexion of DIPs and PIPs; loss of ability to spread fingers due to loss of interossei
40
Q

What causes ape hand? What are the sx?

A
  • Median n. palsy leads to wasting of thenar mm.

- Inability to oppose thumb, thumb is pulled posteriorly and lines up w/other digits

41
Q

What causes Hand of Benediction/Pope’s blessing? What are the sx?

A
  • Median n. palsy leads to deformity only while trying to make fist
  • Inability to flex lateral 3.5 fingers
42
Q

What causes wrist drop?

A

-Radial n. palsy: loss of motor innervation to wrist extensors (usually dmg proximal to elbow joint)